Older adults who live in economically disadvantaged neighborhoods spend significantly fewer days at home in the year after a fall-related hip fracture than those living in more affluent areas, according to a large national study published today in JAMA Network Open.

The study analyzed Medicare data from more than 52,000 older adults who experienced a hip fracture. Researchers found that people living in the most disadvantaged neighborhoods spent about 23 fewer days at home during the year after their injury compared with those in the least disadvantaged areas after considering individual factors such as age or chronic illnesses. 

“Neighborhood context is a critical determinant of health, but it’s often overlooked in hip fracture research,” said study senior author Jason R. Falvey, DPT, PhD, Associate Professor of Physical Therapy and Rehabilitation Science at the University of Maryland School of Medicine. “Older adults in neighborhoods like West Baltimore face compounded challenges limited ability to get to rehabilitation services, fewer supports for caregivers, and neighborhood factors like broken sidewalks that impede mobility. These realities make it harder to regain independence after a hip fracture.”

Using the Area Deprivation Index (ADI) a national measure capturing factors such as income, education, employment, and housing quality the researchers categorized patients’ neighborhoods by level of economic deprivation. Those in the most deprived neighborhoods were also more likely to identify as members of racial or ethnic minority groups and to be dually eligible for Medicare and Medicaid.

“These findings point to the urgent need for community-tailored recovery programs and policy interventions that go beyond hospital walls,” added Dr. Falvey, who is also Director of the School’s Center for Disability Justice. “By investing in community-level resources, caregiver supports, and safe neighborhood infrastructure, we can help more older adults recover and age in place no matter where they live”.

Source: https://www.medschool.umaryland.edu/news/2025/new-study-finds-where-you-live-affects-recovery-after-a-hip-fracture.html